New York City Employee Sentenced in Manhattan Federal Court in Million-Dollar Medicaid Fraud

New York City Employee Sentenced in Manhattan Federal Court in Million-Dollar Medicaid Fraud

Preet Bharara, United States Attorney for the Southern District of New York, announced today that AKIM MURRAY was sentenced in Manhattan federal court to 63 months in prison for orchestrating a substantial Medicaid fraud. MURRAY, a former employee of the Medicaid Reimbursement Unit of the New York City Human Resources Administration (“HRA”), was sentenced today by U.S. District Judge Richard M. Berman. MURRAY pled guilty in September 2014 to one count of conspiracy to commit health care fraud for abusing his access as an HRA employee in order to have dozens of checks amounting to over a million dollars issued to his friends and criminal associates, who in turn gave him a substantial cut of the proceeds.

Manhattan U.S. Attorney Bharara said: “Taking money meant for people in need, Akim Murray used his position as a New York City employee to divert over a million dollars to himself and his friends. City employees who abuse their access in similar ways should heed the lesson in his deserved prison sentence: this office and its law enforcement partners will not tolerate such conduct.”

According to the allegations in the Complaint and other documents, and statements made in Manhattan federal court:

Medicaid is a federally funded program designed to provide low-income families with affordable health care. The New York City Human Resources Administration oversees the program and processes applications from New York City residents. Under Medicaid, individuals who successfully apply for Medicaid coverage can be reimbursed for eligible expenses submitted in the approximately three-month period prior to the application (“Pre-Enrollment Services”). In order to be reimbursed for Pre-Enrollment Services, the successful Medicaid applicant requesting reimbursement must provide proof that he or she made eligible health care payments out of pocket before applying for Medicaid. City employees known as Eligibility Specialists, working for HRA’s Medicaid Reimbursement Unit, receive and process requests for reimbursement using a computer system, and make recommendations for HRA supervisors as to whether a request should be approved.

From at least July 2009 until September 2010, MURRAY, an HRA Eligibility Specialist, exploited loopholes in HRA’s computer systems to both recommend and then separately approve the issuance of Medicaid reimbursement checks without meaningful oversight. MURRAY used the personal identifying information of his co-conspirators to create and unilaterally approve requests for reimbursement checks in their names. When the checks were sent to his friends and other associates, MURRAY demanded that they cash the checks and give him between 50-70% of the proceeds. MURRAY approved over $1 million in Medicaid reimbursement requests without proper oversight.

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MURRAY, 53, of New York, New York, was also sentenced to three years of supervised release, and ordered to pay $1,383,501.15 in restitution and $100,000 in forfeiture.

Mr. Bharara praised the investigative work of the FBI’s Health Care Fraud Task Force and the DOI for their assistance in this investigation, which he noted is ongoing. The New York FBI Health Care Fraud Task Force was formed in 2007 in an effort to combat health care fraud in the greater New York City area. The task force comprises agents, officers, and investigators from the FBI, NYPD, the New York State Insurance Fraud Bureau, U.S. Department of Labor, U.S. Office of Personnel Management Inspector General, U.S. Food and Drug Administration, New York State Attorney General’s Office, New York State Office of Medicaid Inspector General, New York State Health and Hospitals Inspector General, and the National Insurance Crime Bureau.

This case is being handled by the Office’s Public Corruption Unit. Assistant United States Attorney Martin S. Bell is in charge of the prosecution.